Amino acid derivatives containing a disulfanyl group as an inhibitor of nep and apn for the prevention and treatment of trigeminal nerve pain

ABSTRACT

The present invention concerns a pharmaceutically acceptable salt of a compound of the following formula (I): H 2 N—CH(R 1 )—CH 2 S—S—CH 2 —CH(R 2 —CONH—CH(R 3 )—COOR 4  (I) and more particularly an acid addition salt thereof, and the compositions comprising the same, for use in the prevention or treatment of trigeminal nerve pain, in particular migraines or trigeminal neuralgia.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application is a divisional of U.S. National Stageapplication Ser. No. 16/964,779 filed Jul. 24, 2020, which claimspriority to International Patent Application No. PCT/EP2019/051904 filedJan. 25, 2019, which claims the benefit of priority of French PatentApplication No. 1850630 filed Jan. 26, 2018, the respective disclosuresof which are each incorporated herein by reference in their entireties.

BACKGROUND Field of the Disclosure

The present invention relates to mixed disulfide compounds comprising anNEP inhibitor and an APN inhibitor (on either side of a disulfidebridge) for their use for the prevention and/or treatment of trigeminalnerve pains.

Technological Background

The Trigeminal Nerve

Pain is a nociceptive response related to local stimulation in the body.The perception thereof in the central nervous system requires thetransmission of pain stimuli by the peripheral nerve fibers. When thetissues are stimulated, whether by thermal, mechanical or chemicalstimuli, electrochemical signals are transmitted from the sensory nerveendings to the spinal column and then to the brain where the pain isfelt.

There are different types of pain, of widely varied origin whosetreatments are radically different depending on the type of pain and itsetiology.

The trigeminal system, for example, is involved in nociceptive phenomenaoriginating from oral, facial and cranial areas, but with very specificnociception characteristics, which has an impact on treatment. Indeed,craniofacial structures such as the cornea, the meninges and the dentalpulp give rise to painful sensations in humans, but the most frequentlyencountered, such as dental pain, are often difficult to localize, andsome headaches may occur even in the absence of any identifiableexternal cause.

The trigeminal nerve, the fifth pair of cranial nerves, is made up ofthree branches: the ophthalmic (V1), maxillary (V2), and mandibular (V3)divisions. Each division innervates one of the three dermatomes of theface as well as the underlying mucosal, vascular, muscle and meningestissues. In all mammals, the ophthalmic branch, solely sensory,innervates the cornea, the neighboring conjunctiva, the tip of the nose,the intranasal mucosa, the upper eyelid and the supraorbital skin, apart of the meninges (dura mater and blood vessels) as well as the skinof the forehead and the scalp. The maxillary division, also solelysensory, innervates the infraorbital and postorbital skin, the upperlip, the alae of the nose, the intraoral maxillary mucosa and the teethof the upper jaw. The mandibular branch, both sensory and motor,innervates the temporomandibular joint, the skin of the lower lip, theintraoral mandibular mucosa, the teeth of the lowerjaw and the anteriorpart of the tongue. The transmission of acute pain involves theactivation of various sensory receptor groups on peripheral Ab and Cfibers as well as nociceptors, which respond to adverse mechanical,thermal and chemical stimuli.

The sensory pathways that transmit craniofacial nociceptive stimuli tohigher stages of the brain originate from trigeminal ganglionnociceptors and their associated nuclei in the sensory complex of thetrigeminal brainstem and upper cervical spinal cord. These structuressimultaneously collect basic activities coming from numerous sourcesthat are not only relevant for pain, but which may also play a role inthe continuous transmission of crucial information to maintain theintegrity of the craniofacial regions. Certain specific characteristicsof trigeminal nociception may therefore result not only from the uniqueanatomical and functional organization of the nuclei of the trigeminalbrainstem, but also from the interaction between central ascending anddescending mechanisms.

Orofacial pain disorders constitute a major and costly component ofhealthcare and have a high prevalence with a disproportionallydevastating impact on quality of life (American Department of Health andHuman Services, 2000) “ . . . oral health means much more than healthyteeth. It means being free of chronic oral-facial pain conditions . . .”. Community surveys indicate that many subjects generally report painin the orofacial region, with estimates of more than 39 million, or 22%of the adult population, in the United States alone (Lipton et al., J AmDental Assoc (1993), 124: 115-121). Other population surveys conductedin the United Kingdom (Macfarlane et al., Pain (2002), 99: 453-458),Germany (Torsten et al., Pain (2003), 102: 257-263) or regional paincenters in the United States (Dworkin et al., J Am Dent Assoc (1990),120: 273-281) report similar levels (Pau et al., Oral Health &Preventive Dentistry (2003), 1: 209-220). Moreover, orofacial painoriginates from numerous specific target tissues, such as the meninges,the cornea, the dental pulp, the oral and nasal mucosa, and thetemporomandibularjoint and therefore have several specific physiologicalcharacteristics relative to the nociceptive system connected to thespinal cord (Bereiter et al., The senses, a comprehensive reference(2008), vol. 5: 435-460 Academic Press San Diego, Calif.).

Trigeminal neuralgia (TN) is a common cause of acute recurrent headache,particularly involving women age 50 or older. It leads to significantpain, which can be very debilitating and a major source of psychologicaldistress in severe cases. Its incidence is around twenty annual casesper 100,000 inhabitants. It is twice as common in women and itsfrequency increases with age.

There are two types of trigeminal neuralgia. Essential neuralgia, wherethe pain is unilateral, involves a part of the face corresponding to oneof the sensory territories of the trigeminal. It is blazing, veryintense, like burning or electrical shock, typically lasting a fewseconds to a few minutes. Symptomatic trigeminal neuralgia is notgenerally paroxysmal but rather background pain. It also involvesseveral regions of the trigeminal nerve.

Another pain associated with the trigeminal nerve, migraines representone of the most common human disorders, involving 10 to 15% of the adultpopulation with a clear predominance in women. Migraine is aneurological disorder associated with episodal manifestations orattacks, typically characterized by severe headaches lasting 4 to 72hours, accompanied by malfunction of the autonomous nervous system andvarious neurological problems such as cutaneous allodynia (Goadsby etal., Physiol. Rev. (2017), 97: 553-622). When these problems areoccasional, random, irregularly spaced and their number does notincrease over time, they are called acute migraines. In some cases, thefrequency of attacks increases, becoming chronic, a very debilitatingform defined by headaches for 15 days or more a month. These are calledchronic migraines.

Migraine attacks often lead to difficulty, even inability to livenormally. Migraine sufferers often isolate themselves in a quiet anddark area. The financial burden is also enormous for society. The annualuse of healthcare may exceed a billion dollars for migraine patients,while the lost productivity for employers may reach billions of dollars(Hu X H et al., Arch Intern Med (1999), 159 (8): 813-818). Certaincomorbidities are present in migraine patients with a higher prevalence,such as stroke, angina pectoris, epilepsy, and some psychiatricdisorders such as depression and anxiety.

Clinical studies have identified risk factors for chronic migraine. Oneis the frequency of headache attacks (Scher I A et al., Pain (2003),106: 81-89), another is cutaneous allodynia. Two-thirds of migrainespresent allodynia, during (Ashkenasi A et al., Cephalalgia (2007), 27;111-117) and between migraine attacks (Schwedt T J et al., Cephalalgia(2011), 31: 6-12). The development and severity of cutaneous allodyniaare associated with frequent migraine attacks and are predictive ofchronic migraine (Bigal M E et al., Curr Opin Neurol (2009), 22:269-276).

Migraine treatment therefore should be initiated at the start of theattack, as early as possible. Grade 1 analgesics and NSAIDs(nonsteroidal antiinflammatory drugs) are sufficient for moderate forms.For patients whose attacks are more intense, treatment requires the useof triptans, such as sumatriptan, oral or injectable, to directly treatheadache.

In cases of chronic migraines, prophylactic agents leading to areduction in the frequency and severity of attacks are often prescribed.Propranolol, a beta blocker, has been one of the most commonly usedpreventative medications for a long time (Loder E et al., Headache(2012), 52: 930-945); this treatment reduces headache frequency innearly 50% of patients (Stovner L J et al., Cephalalgia (2014), 34:523-532). However, its mechanism and site of action remain poorlyunderstood.

Although millions of Americans suffer migraines, only around 3% to 13%of them are on a preventative treatment, even though 38% could use apreventative agent (Lipton R B et al., Neurology (2007), 68(5) 343-349).Pharmacological interventions in the treatment of migraines comprise anacute treatment, for purposes of ending attacks, and a dailypreventative treatment. The 2000 US Headache Consortium defined thefollowing objectives regarding preventative treatment: (1) decreaseattack frequency by 50% and decrease intensity and duration; (2) improveresponsiveness to acute therapy; (3) improve function and decreasedisability; and (4) prevent the occurrence of analgesic medicationoveruse headaches and prevent the occurrence of chronic headaches. Betablockers such as propranolol are the most commonly used class ofmigraine prophylactic medications and are effective in 50% of cases, butothers, such as tricyclic antidepressants, calcium channel blockers,CGRP antagonists, antiepileptics and nonsteroidal anti-inflammatorydrugs can also be used. (Silberstein S D, Continuum (2015), 21(4):973-989).

Disorders such as multiple sclerosis may cause secondary trigeminalneuralgia.

The treatment of essential trigeminal neuralgia is mainly medical andsometimes surgical. Medical treatment uses carbamazepine as a first-linetreatment, with progressive dose increase up to the minimum effectivedose. Other drugs are used: oxcarbazepine, baclofen, clonazepam,lamotrigine, gabapentin or pregabalin.

Various medications and surgical procedures have been used for treatmentof trigeminal neuralgia (TN). Despite the numerous available approaches,the results are far from satisfactory. Moreover, a certain number ofpatients become drug resistant, which requires surgical treatment totreat the neuralgia. However, pain frequently recurs after one or moresurgical procedures (Montano et al., Ther Clin Risk Manag (2015), 11:289-299).

Pain related to multiple sclerosis may be nociceptive or neuropathic, ora mixture thereof. Specific conditions include trigeminal neuralgia andLhermitte® sign. These are associated with extreme pain, painful tonicspasms, optical nerve pain, muscle pain and migraines (Truini et al., JNeurol (2013), 260: 351-367).

Experimental autoimmune encephalitis (EAE) is the most widely usedexperimental model of multiple sclerosis. It shares numerouspathological characteristics with human cases, such as neuroinflammationand demyelinization and neuron damage (Duffy et al., Mult Scler Int(2014) 285245. doi: 10.1155/2014/285245). Although it is not completelyclear, it seems that the pain generated in this model is the result ofinflammation, glial activation and demyelinization (Olechowski et al.,Pain (2009), 141: 156-164) as well as a process related to thetrigeminal nerve (Thorburn et al., Pain (2016), 157(3): 627-642).

The Analgesic Effect of Enkephalins

Perception, transmission and regulation of nociceptive impulses dependon several neurotransmitters, especially enkephalins (met-enkephalin andleu-enkephalin). These are endogenous opioid pentapeptides, initiallyfound in mammal brains (Hugues et al., Nature (1975), 258, 577-579).They are mainly related to two receptor classes, μ and δ opioidreceptors (Waterfield et al., Eur J Pharmacol (1979), 58: 11-18) withdifferent functions and locations (Waksman et al., Proc Natl Acad SciUSA (1986), 83: 1523-1527).

The antinociceptive properties of enkephalins have been demonstratedafter intracerebroventricular administration of exogenic enkephalins(Belluzi et al., Nature (1976), 260: 625-626). However, this response isvery fleeting due to rapid enzyme metabolization of these peptides.Synthetic enkephalin analogs, modified to make them resistant toenzymatic degradation, have shown antinociceptive properties equal tothose of morphine, but have also presented the same adverse sideeffects.

Moreover, it is known that enkephalins (tyr-gly-gly-phe-met andtyr-gly-gly-phe-leu) are physiologically deactivated by two zincmetallopeptidases, neprilysin (EC 3.4.24.11, NEP) which cleaves thegly³-phe⁴ bond (Malfroy et al., Nature (1978), 276: 523-526) andaminopeptidase N (EC 3.4.11.2, APN) which cleaves the tyr¹-gly² bond ofthese peptides (Waksman et al., Eur J Pharmacol (1985), 117: 233-243).

The inhibition of these two enzymatic activities, by completelyprotecting enkephalins (Bourgoin et al., J Pharm Exp Ther (1986), 238(1), 360-366), display the analgesic and antidepressant pharmacologicalactivities of endogenous opiates, the enkephalins (Roques, TrendsPharmacol Sci (2000), 21, 475-483; Jutkiewicz, CNS Drug Rev (2007), 13,192-205).

Interactions Between the Enkephalinergic System and the Trigeminal Nerve

Opioid receptors are present in the caudate nucleus of the rat and cattrigeminal (Wang, J Neurophysiol (2000), 83: 3570-3574).

Delta receptors are involved in the migraine mechanism (Charles &Pradhan, Curr Opin (2016), 29: 314-319). Indeed, delta agonists (e.g.SNC80) inhibit the hyperalgesia related to migraine in mice (Pradhan etal., Br J Pharmacol (2014), 171: 2375-2384).

In cases of trigeminal nerve neuropathy, continuous activation ofendogenous opioid neurotransmission has been demonstrated, occurringmainly by activation of mu receptors (Da Silva et al., Curr PainHeadache Rep (2014), 18: 429. doi: 10.1007/s11916-014-0429-0). In thesame way, an increase of met-ENK has been observed in migraine patients(Mosnaim et al., Headache (1986), 26: 278-281).

In cases of migraine, mu receptors modulate nociceptive signals (Storeret al., Br J Pharmacol (2003), 138: 317-324). Indeed, it wasdemonstrated that a mutation of the mu receptor gene increasedsensitivity to migraine attacks (Menon et al., Pain (2012), 13:513-519). A peripheral mu agonist action has also been demonstrated(Baillie et al., Neuropharmacol (2015), 93: 267-273).

Opioids (morphine, codeine and pethidine) are effective in migraine(Siberstein, Cephalalgia (2000), 20: 854-864). In fact, it has beendemonstrated that opioid agonists inhibit neurogenic meningealvasodilatation (Williamson et al., Br J Pharmacol (2001), 133: 807-814),as do triptans.

Transfer by means of herpes simplex virus type-1 (HSV-1) permitsoverexpression of pro-enkephalins in primary sensory neurons in thelumbar region. Such an administration showed an anti-hyperalgesic effectin a chronic pain model in rats or in a neuropathic model resulting fromspinal nerve ligature (Hao et al., Pain (2003), 102: 135-142). Unlikemorphine, this type of treatment did not show tolerance after 4 weeks oftreatment or after 8 weeks of treatment (Hao et al., Pain (2003), 102:135-142). In contrast, resistance was observed during morphine treatment(Meunier et al., Mol Therap (2005), 11: 608-616).

There is therefore a need for preventative therapy and improvedtreatments for trigeminal nerve pains, especially migraines, ortrigeminal neuralgia, which avoid the side effects of known treatments,in particular the phenomena of addiction and habituation. In cases ofchronic migraine, for example, with a preventive medication, thefrequency of migraines may be reduced and the acute treatment responseimproved, which reduces healthcare costs and the number of lost workdays and improves patient quality of life.

SUMMARY

Mixed inhibitors of enzymatic degradation of endogenous enkephalins havemade it possible to completely reveal the pharmacological activitiesand, in particular, the analgesic and antidepressant activities ofenkephalins. Different series of mixed inhibitors have been described indifferent patents (WO 98/18803; WO 2009/138436; WO 2010/010106; WO2014/064166).

Good antinociceptive efficacy was demonstrated in numerous acute orneuropathic pain models (Poras et al., J Med Chem (2014), 57: 5748-5763;Bonnard et al., Pharma Res Per (2015), 3(2), e00116, doi:10.1002/prp2.116; Poras et al., Eur J Med Chem (2015), 102: 58-67).However, the use of these compounds as analgesics acting on painsspecifically relating to the trigeminal nerve, such as migraine ortrigeminal neuralgia, has never been described or suggested.

However, surprisingly, the inventors have demonstrated that amino acidderivatives containing a disulfanyl group, described as mixed NEP andAPN inhibitors and having analgesic activities in central or peripheralpain models after intravenous or oral administration, are effective forthe prevention and treatment of pains related to the trigeminal nerve,especially for migraines treatment, whether chronic or acute.

According to another embodiment, amino acid derivatives containing adisulfanyl group according to the invention are effective in thetreatment and prevention of migraine attacks.

Unlike the method involving transfer using herpes simplex virus type-1(HSV-1) cited previously, an overexpression of enkephalin within thenervous system is not sought via the use of these mixed NEP and APNinhibitors.

The invention therefore relates to a pharmaceutically-acceptable salt ofa compound of formula (I) to prevent or treat trigeminal nerve pains, inparticular migraines or trigeminal neuralgia:

H₂N—CH(R₁)—CH₂—S—S—CH₂—CH(R₂)—CONH—CH(R₃)—COOR₄  (I)

wherein:

-   -   R₁ represents:        -   a saturated or unsaturated, linear or branched hydrocarbon            chain, containing 1 to 6 carbon atoms, optionally            substituted by:            -   an OR, SR or S(O)R radical, in each of these radicals, R                represents a hydrogen, a linear or branched hydrocarbon                chain of 1 to 4 carbon atoms, a phenyl or benzyl                radical,            -   a phenyl or benzyl radical,        -   a phenyl or benzyl radical optionally substituted by:            -   1 to 5 halogen atoms, notably fluorine,            -   an OR, SR or S(O)R radical, R having the same meaning as                previously in each of these radicals,        -   a methylene radical substituted by a 5 or 6 atom            heterocycle, aromatic or saturated, having a nitrogen or            sulfur atom as heteroatom, optionally oxidized in the form            of N-oxide or S-oxide;    -   R₂ represents:        -   a phenyl or benzyl radical optionally substituted by:            -   1 to 5 halogens, notably fluorine,            -   an OR or SR radical, R having the same meaning as                previously in each of these radicals,            -   an amino group, optionally mono- or disubstituted by a                cyclic or linear aliphatic group, of 1 to 6 carbon                atoms,            -   a 5 or 6 atom aromatic ring,        -   an aromatic heterocycle with 5 to 6 atoms, the heteroatom            being an oxygen, nitrogen or sulfur,        -   a methylene group substituted by a 5 or 6 atom heterocycle,            aromatic or saturated, the heteroatom being an oxygen,            nitrogen or sulfur, the nitrogen and sulfur atoms optionally            being oxidized in the form of N-oxide or S-oxide;    -   R₃ represents:        -   a hydrogen,        -   an OH or OR group, R having the same meaning as previously,        -   a saturated hydrocarbon (alkyl) chain, linear or branched,            having 1 to 6 carbon atoms, optionally substituted by an OR            or SR radical, in each of these radicals, R has the same            meaning as previously,        -   a phenyl or benzyl radical optionally substituted by:            -   1 to 5 halogens, notably fluorine,        -   an OR or SR group, R having the same meaning as previously,            and    -   OR₄ represents:        -   a glycolate OCH₂COOR′ or lactate OCH(CH₃)COOR′ radical, in            each of these radicals, R represents:            -   a saturated hydrocarbon chain (alkyl) with 1 to 6 carbon                atoms, linear or branched, optionally substituted by a                C₁-C₃ alkoxy group, preferably a C₁-C₄ alkyl group                optionally substituted by a methoxy group,            -   a C₅-C₈, cycloalkyl group, preferably a C₅-C₆ cycloalkyl                group,            -   a phenyl, benzyl, heteroaryl or alkyl heteroaryl group;        -   an OCH(R″)O(CO)OR′ or OCH(R″)O(CO)R′ group, in each of these            radicals, R has the same meaning as previously and R″            represents:            -   a hydrogen atom,            -   a linear or branched C₁-C₆ alkyl chain optionally                substituted by a C₁-C₃ alkoxy group, preferably a C₁-C₄                alkyl group optionally substituted by a methoxy group,            -   a C₅-C₈, cycloalkyl group, preferably a C₅-C₆ cycloalkyl                group,            -   a phenyl, benzyl, heteroaryl or alkyl heteroaryl group;        -   an OCH(CH₂OCOR′)₂ or OCH₂—CH(OCOR′)—CH₂OCOR′ triglyceride            radical, R′ having the same meaning as previously in each of            these radicals;        -   a glycoside radical such as D-glucose, β-D-glucopyranose, α-            or β-galactopyranose;        -   a sulfonate OCH₂CH₂(SO₂)CH₃ radical;        -   an OCH(CH₂OH)₂ radical.

The present invention also relates to a composition, notably for its useto prevent or relieve (treat) trigeminal nerve pains, said compositioncomprising as active ingredient at least one pharmaceutically-acceptablesalt of a compound of formula (I) of the invention, and at least onepharmaceutically-acceptable excipient.

The present invention also relates to a composition, notably for its useto prevent migraine attacks, said composition comprising as activeingredient at least one pharmaceutically-acceptable salt of a compoundof formula (I) of the invention, and at least onepharmaceutically-acceptable excipient.

The present invention also relates to a pharmaceutically-acceptable saltof a compound of formula (I), or a composition containing it, for theproduction of a medication to prevent or relieve (treat) trigeminalnerve pains, in particular migraine or trigeminal neuralgia.

The present invention also relates to the use of apharmaceutically-acceptable salt of a compound of formula (I), or acompound containing it, for the production of a drug to prevent migraineattacks.

The present invention also relates to a method for preventing ortreating trigeminal nerve pains, in particular migraines or trigeminalneuralgia, comprising the administration of an effective dose of apharmaceutically-acceptable salt of a compound of formula (I), or acomposition comprising it, to a patient in need thereof.

The present invention also relates to a method for preventing migrainesattacks comprising the administration of an effective dose of apharmaceutically-acceptable salt of a compound of formula (I), or acomposition comprising it, to a patient in need thereof.

The present invention also relates to a composition comprising aquantity comprised between 50 mg and 800 mg, of a salt of a compound offormula (I) or a salt of formula (II).

In the present invention, the patient (suffering from trigeminal nervepains, in particular migraine attacks) is typically an animal,preferably a mammal, advantageously it is a human.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a graph showing the comparative tail withdrawal latency time(in seconds) for a control group (with carrier or 20 minutes after IPinjection of a dose of 50 mg/kg of compound 1), and the EAE model group(with carrier or after 30 minutes after injection of a dose of 50 mg/kgor 100 mg/kg of compound 1);

FIG. 2 is graph showing the von Frey force necessary to bring about headwithdrawal (in g) as a function of time (minutes) after IV injection ofa saline solution (carrier, black square), a solution of compound 1(black circle), or sumatriptan (gray triangle).

FIG. 3 is graph showing the von Frey force necessary to bring about headwithdrawal (in g) as a function of time (minutes) after oraladministration of a saline solution (carrier, black square), a solutionof compound 1 (black circle) or rizatriptan (gray triangle);

FIG. 4 is a graph showing the von Frey force necessary to bring abouthead withdrawal (in g) as a function of time (minutes) after oraladministration of a saline solution (carrier, black circle) or compound1 (PL37, gray circle, 50 mg/kg);

FIG. 5 is a graph showing the von Frey force necessary to bring abouthead withdrawal (in g) as measured at t=0 before oral administration ofsaline solution (carrier, black circle) or compound 1 (gray circle, 50mg/kg) measured for 5 days;

FIG. 6 is a graph showing the von Frey force necessary to bring abouthead withdrawal (in g) as a function of time (minutes) after oraladministration of a saline solution (carrier, black circle) or compound1 (gray circle, 50 mg/kg once daily).

DETAILED DESCRIPTION

In the context of the present invention “trigeminal nerve pain” meanspain relating to the sensory part of the trigeminal. “Pain relating tothe sensory part of the trigeminal”, according to the present invention,covers different types of pain originating from the sensory part of thetrigeminal nerve. In particular, it is a question of craniofacial pain,and especially orofacial pain. It can also be pain located in thecornea, meninges or dental pulp, the dermatomas of the face, mucosaltissues, vascular tissues or muscle tissues. It may also be pain locatedin the cornea, conjunctiva, nose, intranasal mucosa, eyelids,supraorbital skin, forehead, scalp, lips, jaw, tongue, gums or oralmucosa.

In particular, it is a migraine or trigeminal neuralgia, especiallyessential trigeminal neuralgia and symptomatic trigeminal neuralgia. Itmay also be headaches, especially acute headaches, in particularrecurrent, or their symptoms such as cephalic cutaneous allodynia. Itmay also be peripheral trigeminal pain associated with multiplesclerosis.

In the context of the present invention, the term “migraine” refers toboth acute migraine, which defines an occasional headache lasting 4 to72 hours occurring less than 15 days a month, and chronic migraine,which is characterized by chronic headaches, with headaches that recurrepeatedly either for no apparent reason, or following exposure of thepatient to a triggering factor (such as bright light, menstruation,etc.) fifteen days or more a month (Headache Classification Committee ofthe International Headache Society (IHS). The InternationalClassification of Headache Disorders, 3rd edition, Cephalalgia (2013),33: 629-808).

In the context of the present invention, the terms “migraine attacks” or“chronic migraine” are interchangeable.

In the sense of the present invention, treatment means the attenuationor resolution of pain. In this case, the compound or compositionaccording to the invention is administered after onset of pain.

In the sense of the present invention, prevention means that the painhas not started and the compound or composition according to theinvention is administered before the onset of pain, thereby preventingsaid onset of pain or attenuating future pain.

In the sense of the present invention, “therapeutic dose” means thedaily quantity of active ingredient (for example salt of the compound offormula (I)) administered to the patient having need thereof.

“Repeatedly” means that the therapeutic dose or compositions of theinvention, as applicable, are administered by administrations staggeredover time for a period ranging from several days to several months, mostoften with regular time intervals between administrations.

In the sense of the present invention, “amino” group means a group offormula —NR*R**, where R* and R** represent, independently of oneanother, a hydrogen atom or a saturated or unsaturated, linear, branchedor cyclic hydrocarbon group containing 1 to 6, preferably 1 to 4, carbonatoms, or R* and R** form together, with the nitrogen atom which carriesthem, a 5- or 6-membered heterocycle, saturated or unsaturated, andhaving no other heteroatom other than the nitrogen which carries boththe R* and R** radicals. In particular, the amino group may be an —NH₂,—NHMe, —NHEt, —NHPr, NHiPr, —NHBu, —NHiBu, —NHtBu, piperidinyl orpyrrolidinyl group. Preferably, an amino group is a group of the formula—NR*R**, where R* and R** represent, independently of one another, ahydrogen atom or a linear or branched C₁-C₆ alkyl group (preferablyC₁-C₄).

In the context of the present invention, the term “hydrocarbon chain”designates alkanes, alkenes or alkynes. In particular, the expression“saturated hydrocarbon chain” designates alkyl radicals with 1 to 6carbon atoms (C₁-C₆) or 1 to 4 carbon atoms (C₁-C₄), linear or branched.Examples of alkyl radicals having 1 to 4 carbon atoms include methyl,ethyl, propyl, butyl, isopropyl, 1-methyl-ethyl, 1-methyl-propyl and2-methyl-propyl radicals. Examples of alkyl radicals having 1 to 6carbon atoms include pentyl, hexyl 1-methyl-butyl, 1-methyl-pentyl2-methyl-butyl 2-methyl-pentyl, 3-methyl-butyl, 3-methyl-pentyl,4-methyl-pentyl or 1-ethyl-propyl, 1-ethyl-butyl, 2-ethyl-butylradicals. The expression “unsaturated hydrocarbon chain” designatesalkenyl radicals (at least one double bond), for example vinyl, allyl orthe like, or alkynyl radicals (at least one triple bond) containing 2 to6 carbon atoms, or 2 to 4 carbon atoms, linear or branched.

In the sense of the present invention, “cycloalkyl” means a saturatedhydrocarbon ring containing 5 to 8 carbon atoms, in particular thecyclohexyl, cyclopentyl or cycloheptyl group.

The term “halogen” used here designates a chlorine, a bromine, an iodineand a fluorine. Advantageously, it is a fluorine, bromine or chlorineatom. More advantageously, it is a fluorine or bromine atom, andpreferably fluorine.

In the sense of the present invention, “aromatic” means an aromaticgroup, preferably containing 5 to 10 carbon atoms, unless otherwisestated, and comprising one or more fused rings, such as, for example, aphenyl or naphthyl group. Advantageously it is phenyl.

In the sense of the present invention, “heteroaromatic” group or radicalmeans any aromatic group as defined above in which one or more carbonatoms have been replaced by one or more heteroatoms, advantageously 1 to4 and even more advantageously 1 to 2, such as, for example, sulfur,nitrogen or oxygen atoms, the sulfur and nitrogen atoms possibly beingoxidized in the form of S-oxide or N-oxide. Examples of heteroaromaticgroups are furyl, thienyl, pyrrolyl, pyridinyl, pyrimidyl, pyrazolyl,imidazolyl, tetrazolyl or indyl groups. Preferably, it is a thienylgroup.

In the sense of the present invention, “heteroaromatic ring with 5 or 6atoms” means a heteroaromatic group such as defined above comprisingonly a single 5- or 6-atom ring. This is particularly a thienyl,pyrrolyl, pyridinyl, pyrimidyl, pyrazolyl, imidazolyl or tetrazolylgroup.

In the sense of the present invention, “heterocycle” means a hydrocarbonring advantageously with 5 or 6 atoms, of which one or more carbon atomshave been replaced by one or more heteroatoms, advantageously 1 to 4 andeven more advantageously 1 to 2, such as, for example, sulfur, nitrogenor oxygen atoms, the sulfur and nitrogen atoms possibly being oxidizedin the form of S-oxide or N-oxide. Unless otherwise stated, this ringmay be saturated or aromatic. Examples of aromatic or saturated 5- or6-membered heterocyclic rings having a nitrogen or sulfur atom as theheteroatom include, but are not limited to, the following radicals:thienyl, pyrrolyl, imidazolyl, pyrazolyl, isothiazolyl, pyridyl,pyrazinyl, pyrimidinyl, pyridazinyl, pyrrolidinyl, pyrrolinyl,imidazolidinyl, pyrazolidinyl, pyrazolinyl, piperidyl, piperazinyl,thiadiazolyl, the nitrogen and sulfur atoms being optionally oxidized inthe form of N-oxide or S-oxide. Examples of heterocyclic rings with 5 or6 atoms, aromatic or saturated, having an oxygen atom as the heteroatominclude, but are not limited to, the following radicals: furyl, pyranyl,isoxazolyl, morpholinyl, furazanyl, oxazolyl, oxazolidinyl, oxazolinyl.

Compounds of formula (I) potentially have 2 to 9 asymmetric centers. Theradicals R₁, R₂ and R₃ are typically introduced so as to obtainoptically pure sequences corresponding to a stereochemistry recognizedby enzymatic activities. R₄ radicals may optionally contain anunresolved asymmetric center.

Compounds of the invention are in the form ofpharmaceutically-acceptable salts, or a hydrate thereof. In the presentinvention, “pharmaceutically acceptable” means something usable in thepreparation of a pharmaceutical composition that is generally safe,nontoxic and neither biologically or otherwise undesirable and which isacceptable for veterinary use as well as a human pharmaceutical.

“Pharmaceutically-acceptable salts” of a compound means salts that arepharmaceutically acceptable, as defined here, and which have the desiredpharmacological activity of a parent compound. Such salts include:

(1) pharmaceutically-acceptable acid addition salts formed with acids,and

(2) hydrates and solvates thereof.

Typically, compounds of formula (I) are in the form of addition saltsobtained with pharmacologically-acceptable organic or mineral acids suchas phosphates, hydrochloride, acetate, methanesulfonate, borate,lactate, fumarate, succinate, hemisuccinate, citrate, tartrate,hemitartrate, maleate, ascorbate, hemifumarate, hexanoate, heptanoate,hippurate, hydrocinnamate, phenylglyoxylate and nicotinate.

The solvate is preferably an alcoholate, such as an ethanolate.

Preferably, the compounds of the invention are in the form of fumaratesalts, or a hydrate thereof.

Radical R₁ advantageously represents an alkyl radical with 1 to 6 or 1to 4 carbon atoms, optionally substituted by an OR, SR or S(O)R,radical, in each of these radicals, R has the same meaning aspreviously, and advantageously represents a hydrogen, a linear orbranched hydrocarbon chain of 1 to 4 carbons, a phenyl or benzylradical. R₁ still more advantageously represents an alkyl radical having1 to 4 carbon atoms substituted by an SR radical, R having the samemeaning as previously, in particular, R represents a saturated linear orbranched hydrocarbon chain of 1 to 4 carbon atoms.

R₂ advantageously represents:

-   -   a phenyl or benzyl group optionally substituted by:        -   1 to 5 halogen atoms, notably fluorine, a hydroxyl or a            thiol, an ether OR or a thioether SR, R having the same            meaning as above,        -   an aromatic ring or aromatic heterocycle with 5 to 6 atoms,            the heteroatom being an oxygen, nitrogen or sulfur,    -   a methylene group substituted by a 5 or 6 atom heterocycle,        aromatic or saturated, the heteroatom being an oxygen, nitrogen        or sulfur, the nitrogen or sulfur atoms optionally being        oxidized in the form of N-oxide or S-oxide;

In particular, radical R₂ represents a benzyl or phenyl radical, or amethylene radical substituted by a 5 or 6 atom heterocycle, aromatic orsaturated, having nitrogen or sulfur as heteroatom, optionally oxidizedin the form of N-oxide or S-oxide; In particular, radical R₂ representsa benzyl or methylene radical substituted by a 5 or 6 atom heterocycle,aromatic or saturated, having nitrogen or sulfur as heteroatom,optionally oxidized in the form of N-oxide or S-oxide, still moreadvantageously a benzyl radical or a methylene radical substituted by athiophenyl radical (thienyl).

Advantageously, radical R₃ represents:

-   -   a hydrogen,    -   an OH or OR group, R having the same meaning as above,    -   a linear or branched C₁-C₆ alkyl, optionally substituted by an        OH, OR, SH or SR group, R having the same meaning as above,    -   a phenyl or benzyl group, optionally substituted by 1 to 5        halogens, notably fluorine or by an OR or SR group, R having the        same meaning as above.

In particular, radical R₃ represents a hydrogen atom or an alkyl radicalwith 1 to 6 carbon atoms, still more advantageously 1 to 4 carbon atoms,optionally substituted by an OR or SR radical, in each of theseradicals, R has the same meaning as previously. Even moreadvantageously, radical R₃ represents a hydrogen atom or an alkylradical with 1 to 6 carbon atoms, still more advantageously 1 to 4carbon atoms, substituted by an OH or SH radical.

Radical OR₄ advantageously represents:

-   -   a glycolate OCH₂COOR′ radical, R′ having the same meaning as        previously (in particular R′ represents a C₁-C₄ alkyl group        optionally substituted by a methoxy group or a C₅-C₆) cycloalkyl        group,    -   an OCH(R″)O(CO)OR′ or OCH(R″)O(CO)R′ radical, R′ and R″ having        the same meaning as previously (in particular R and/or R″        represent a C₁-C₄ alkyl group optionally substituted by a        methoxy group or a C₅-C₆ cycloalkyl group where R″ is a hydrogen        atom),    -   an OCH(CH₂OCOR′)₂ or OCH₂—CH(OCOR′)—CH₂OCOR′ triglyceride        radical, in each of these radicals, R′ having the same meaning        as previously    -   a glycoside radical such as D-glucose,    -   an OCH₂CH₂(SO₂)CH₃ sulfonate radical;    -   an OCH(CH₂OH)₂. radical

Alternatively, radical OR₄ may represent:

-   -   a glycolate OCH₂COOR′ or lactate OCH(CH₃)COOR′ radical;    -   an OCH₂OCOR′ or OCH(CH₃)OCOOR′ group, or    -   an OCH(CH₂OCOR′)₂ or OCH₂—CH(OCOR′)—CH₂OCOR′ triglyceride        radical, R′ representing a linear or branched C₁-C₄ alkyl group.

In particular, radical OR₄ represents an OCH(R″)O(CO)OR′ orOCH(R″)O(CO)R′ group, radical R′ representing a C₁-C₄ alkyl chain (inparticular the ethyl radical) and radical R″ representing a methyl,CH(CH₃)₂, cyclohexyl or phenyl radical.

According to one particular embodiment, the salt of the invention is asalt of formula (II):

A-,H₃N⁺—CH(R₁)—CH₂—S—S—CH₂—CH(R₂)—CONH—CH(R₃)—COOR₄  (II)

wherein:

-   -   A- represents a phosphate, chloride, acetate, methanesulfonate,        borate, lactate, fumarate, succinate, hemisuccinate, citrate,        tartrate, hemi-tartrate, maleate, ascorbate, hemifumarate,        hexanoate, heptanoate, hippurate, hydrocinnamate,        phenylglyoxylate or nicotinate anion;    -   R₁ represents a saturated or unsaturated, linear or branched        hydrocarbon chain, containing 1 to 6 carbon atoms, optionally        substituted by an OR, SR or S(O)R group in which R represents a        hydrogen, a linear or branched hydrocarbon chain of 1-4 carbons,        a phenyl or benzyl radical;    -   R₂ represents:    -   a phenyl or benzyl group optionally substituted by:    -   1 to 5 halogen atoms, notably fluorine, a hydroxyl or a thiol,        an ether OR or a thioether SR, R having the same meaning as        above,    -   an aromatic ring or aromatic heterocycle with 5 to 6 atoms, the        heteroatom being an oxygen, nitrogen or sulfur,    -   a methylene group substituted by a 5 or 6 atom heterocycle,        aromatic or saturated, the heteroatom being an oxygen, nitrogen        or sulfur, the nitrogen or sulfur atoms optionally being        oxidized in the form of N-oxide or S-oxide;    -   R₃ represents:    -   a hydrogen,    -   an OH or OR group, R having the same meaning as above,    -   a linear or branched C₁-C₆ alkyl, optionally substituted by an        OH, OR, SH or SR group, R having the same meaning as above,    -   a phenyl or benzyl group, optionally substituted by 1 to 5        halogens, notably fluorine or by an OR or SR group, R having the        same meaning as above;    -   OR₄ represents:    -   a glycolate OCH₂COOR′ or lactate OCH(CH₃)COOR′ radical;    -   an OCH₂OCOR′ or OCH(CH₃)OCOOR′ group, or    -   an OCH(CH₂OCOR′)₂ or OCH₂—CH(OCOR′)—CH₂OCOR′ triglyceride        radical, R′ representing a linear or branched C₁-C₄ alkyl.

Preferably, in formula (II), A- represents a fumarate anion.

All the combinations of particular, advantageous and preferredembodiments of substituents R₁, R₂, R₃ and R₄ in formulas I and II areenvisaged in the present invention.

In particular, the invention concerns the acid addition salts of thefollowing compounds, in particular fumarate salts thereof:

-   1-(2-(1-(2,3-diacetoxypropoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-ylpropyl    disulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(2-methanesulfonylethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-ylpropyl    disulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(1-ethoxycarbonyloxyethoxycarbonyl))-ethylcarbamoyl)-3-thiophen-3-yl-propyl    disulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-ethoxycarbonylmethyloxycarbonylethylcarbamoyl)-3-thiophen-3-yl-propyl    disulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(1-ethoxycarbonyloxyethoxycarbonyl)-2-hydroxypropylcarbamoyl)-3-thiophen-3-ylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(2-acetoxy-1-acetoxymethylethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-yl    propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(2-hydroxy-1-hydroxymethylethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-yl    propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(3,4,5,6-tetrahydroxytetrahydropyran-2-ylmethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-yl-propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(1-ethoxycarbonyloxy-ethoxycarbonyl)-2-hydroxypropylcarbamoyl)-3-phenyl    propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-(1-(2-acetoxy-1-acetoxymethyl-ethoxycarbonyl)-2-hydroxypropylcarbamoyl)-3-phenylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,-   1-(2-((1-ethoxycarbonyloxy-ethoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyl    disulfanylmethyl)-3-methylsulfanylpropyl-amine,-   3-(2-amino-4-methylsulfanyl-butyldisulfanyl)-2-benzyl-N-(5-ethyl-(1,3,4)-thiadiazol-2-yl)-propionamide,-   1-(2-((1-ethoxycarbonyloxy-2-methyl-propoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,-   1-(2-((cyclohexyl-ethoxycarbonyloxy-methoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,-   1-(2-((ethoxycarbonyloxy-phenyl-methoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,-   3-methylsulfanyl-1-(3-phenyl-2-((1-propionyloxy-ethoxycarbonylmethyl)-carbamoyl)-propyldisulfanylmethyl)-propyl-amine,-   1-(2-((2-methyl-1-propionyloxy-propoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,-   1-(2-((cyclohexyl-propionyloxy-methoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,-   3-methylsulfanyl-1-(3-phenyl-2-((phenyl-propionyloxy-methoxycarbonylmethyl)-carbamoyl)-propyl    disulfanylmethyl)-propyl-amine.

Preferably, the compound of the invention is(5S,10S)-10-benzyl-16-methyl-11,14,18-trioxo-15,17,19-trioxa-2,7,8-trithia-12-azahenicosan-5-aminiumfumarate (or (E)-3-carboxyacrylate) (hereinafter compound 1):

Salts of compounds of formula (I) may be synthesized, for example, bymethods described in WO 2007/048787. More particularly, compound 1 maybe synthesized as described in WO 2017/064250.

Compounds of formula (I) are formulated in accordance with the methodsdescribed by the person skilled in the art for the desiredadministration route.

The invention also relates to pharmaceutical compositions containing asactive ingredient at least one pharmaceutically acceptable salt of acompound of general formula (I) or hydrates of these salts incombination with one or more inert carriers or otherpharmaceutically-acceptable carriers, for use in preventing or relievingtrigeminal nerve pains, particularly migraines or trigeminal neuralgia.

Pharmaceutical compounds according to the invention may be, for example,compositions that can be administered orally, nasally (aerosoladministration), sublingually (administration by perlingual diffusion),rectally, parenterally, intravenously and percutaneously. Examples ofcompounds that can be administered orally include tablets, capsules,granules, microspheres, powders and oral solutions or suspensions. Inparticular, they are soluble in alcohol/polysorbate/water solvents, inparticular ethanol/Tween®/water and mannitol/water or by means ofcyclodextrins suitable for administration in humans, which arefrequently used for intravenous administration. Compositions accordingto the invention may therefore be administered intravenously. They mayalso be administered orally or nasally, in particular via an aerosol orby perlingual diffusion or in an appropriate galenic preparation(microemulsions).

Compositions according to the invention may be administered either inthe aerosol (microemulsion) form orally or nasally or administeredintravenously. These administration routes also permit the compositionaccording to the invention to be administered by a non-digestive route.This is particularly interesting when the composition comprisesadditional compounds, which may have adverse effects on the digestivesystem (in particular the intestine), such as, for example, cannabinoidderivatives. This also permits increasing the bioavailability(especially cerebral) of compounds or associations

Preferably, compositions of the invention are appropriate for oraladministration or intravenous administration.

In one particular embodiment, a formulation of the present inventioncomprises a cyclodextrin, such as hydroxypropyl beta-cyclodextrin orsulfobutyl ether beta-cyclodextrin, or sodium polystyrene sulfonate.

Compositions administered in accordance with the methods described inthe present invention contain an active quantity for use, of a salt of acompound of formula (I) or a salt of formula (II), in particular ofcompound 1. This means a sufficient quantity to prevent or relieve(treat) trigeminal nerve pains, in particular migraines, trigeminalneuralgia, cluster headaches or peripheral trigeminal pains related tomultiple sclerosis.

The therapeutic dose of a compound of the invention varies depending onnumerous parameters such as, for example, the administration routechosen, weight, age, sex, advanced state of the disease to be treatedand the sensitivity of the individual to be treated. Consequently, theoptimum dosage will be determined, depending on the parameters deemedrelevant, by the specialist in the case.

According to the examples of the present invention, the administrationof a daily dose of 4000 mg for 5 consecutive days did not cause theappearance of adverse side effects. The treatment may therefore beadministered for several days without risk of toxicity.

Advantageously, the compositions according to the invention, for theiruse to prevent or treat trigeminal nerve pains, in particular migrainesand trigeminal neuralgia, may include a second active ingredient alreadyknown for pain prevention and treatment.

Another object of the invention is a kit comprising:

-   -   i) A first composition comprising at least one compound of        formula (I) such as defined previously, and    -   ii) A second composition comprising at least a second active        ingredient useful to prevent or treat trigeminal nerve pains as        a combination product for simultaneous, separate or staggered        use.

According to one embodiment, the pharmaceutically-acceptable salt of acompound of formula (I) or a salt of formula (II) according to theinvention, in particular compound 1, is used for the prevention ofmigraine attacks.

The prevention of chronic migraines by the pharmaceutically-acceptablesalt of a compound of formula (I) or of a salt of formula (II) accordingto the invention, in particular of compound 1, is particularly suitablefor patients sensitive to migraines, whose headaches recur periodicallyor are caused by a specific factor such as fatigue, stress,menstruation, bright or artificial light (during long exposure toscreens for example), noise, some odors, certain foods (alcohol). Thepharmaceutically acceptable salt of a compound of formula (I) may alsobe used preventively during the appearance of warning signs of amigraine attack such as an aura, a visual disorder which may manifestitself in the form of a dark spot surrounded by a glittering halo,geometric lines, bright spots in half the field of vision, visual fieldloss, double vision or the temporary loss of vision of one or both eyes.The patient will have identified the risks factors that are highlylikely to induce migraines for them from experience.

According to one embodiment, the pharmaceutical compositions accordingto the invention are used for preventing migraine attacks, in particularmigraine attacks triggered by a specific risk factor such as describedabove.

Thus, preferably, the pharmaceutical compositions used to preventmigraine attacks are administered orally. Advantageously, thesecompositions are administered repeatedly.

Advantageously, a therapeutic dose of a salt of a compound of formula(I) or a salt of formula (II), in particular compound 1 such asdescribed above is administered to a patient in order to preventmigraine attacks. Preferably, said dose is administered for preventingmigraine attacks in patients sensitive to migraine attacks as describedabove. Thus, for preventing migraine attacks, the therapeutic dose isadministered before the onset of pain and/or before exposure to aspecific migraine trigger factor. For example, a women who regularly hasmigraines during her menstrual period could take the therapeutic doseone to several days before the start of her period.

Preferably, in order to prevent migraine attacks, the therapeutic doseadministered to the patient in need thereof is administered repeatedly.Advantageously, the therapeutic dose is administered for preventingmigraine attacks orally or parenterally, advantageously orally, inparticular in galenic form.

The compositions of the invention may advantageously comprise a secondactive ingredient useful for preventing migraine attacks, in particularbeta blockers, antidepressants, anticonvulsants, calcium channelblockers, and/or CGRP inhibitors.

Thus, in order to prevent migraine attacks, the composition alsocomprises a beta blocker, such as atenolol, metoprolol, nadolol,propranolol and/or timolol.

Antidepressants may be selected from amitriptyline, doxepin,nortriptyline, protriptyline and/or venlafaxine. Anticonvulsants may beselected from carbamazepine, gabapentin, topiramate and/orvalproate/divalproex. Calcium channel blockers may be selected fromverapamil, dihydropyridines and/or flunarizine. CGRP (calcitoningene-related peptide) inhibitors are described in Tso A R et al., CurrTreat Options Neurol (2017), 19: 27 DOI 10.1007/s11940-017-0463-4“Anti-CGRP monoclonal antibodies: the next era of migraine prevention?”whose content is incorporated here for reference.

According to one particular embodiment, the composition of the inventionused to prevent migraine attacks, also comprises a second activeingredient selected from beta blockers, antidepressants, calcium channelblockers and/or CGRP inhibitors; advantageously the second activeingredient is selected from propranolol, topiramate or amitriptyline.

Another object of the invention is a kit comprising:

i) a first composition comprising at least one compound of formula (I)such as defined previously, and

ii) a second composition comprising at least one second activeingredient useful for preventing migraine attacks, notably selected frombeta blockers, antidepressants, anticonvulsants, calcium channelblockers and/or CGRP inhibitors, advantageously the second activeingredient is selected from propranolol, topiramate or amitriptyline, ascombination products for simultaneous, separate or staggered use.

This kit may be used as a drug, notably in the prevention of migraineattacks.

According to another embodiment, the pharmaceutically-acceptable salt ofa compound of formula (I) or a salt of formula (II) according to theinvention, in particular compound 1, is used for the treatment oftrigeminal nerve pains, especially migraines or trigeminal neuralgia.

Advantageously, according to the preceding embodiment, thepharmaceutically-acceptable salt of a compound of formula (I) or a saltof formula (II) according to the invention, in particular compound 1, isused for the treatment of acute migraines.

According to one embodiment, the pharmaceutical compositions accordingto the invention are used for the treatment of trigeminal nerve pains,notably migraines or trigeminal neuralgia, in particular acutemigraines. According to one embodiment, a therapeutic dose of a salt ofa compound of formula (I) or a salt of formula (II), in particularcompound 1 such as described above is administered to a patient in orderto treat trigeminal nerve pains. In particular, this dose isadministered to a patient in order to treat migraines, for example acutemigraines.

According to the preceding embodiment, the therapeutic dose to treattrigeminal nerve pains, especially migraines or trigeminal neuralgia, inparticular acute migraines, is administered to the patient when the painoccurs. In the case of acute pain, this dose is generally effective,i.e. a single therapeutic dose is sufficient to attenuate or resolve thepain.

Advantageously, in order to treat trigeminal nerve pain, in particularmigraines or trigeminal neuralgia, the therapeutic dose of a salt of acompound of formula (I) or a salt of formula (II), in particularcompound 1, administered to the patient in need thereof is comprisedbetween 200 and 800 mg.

Preferably, in order to treat trigeminal nerve pains, particularlymigraines, the therapeutic dose such as described above is administeredin one to four administrations. This therapeutic dose may advantageouslybe administered parenterally or orally.

According to another embodiment, the compositions of the invention mayadvantageously comprise a second active ingredient useful to treattrigeminal nerve pains, in particular migraine, especially acutemigraine, chosen from among analgesics, nonsteroidal antiinflammatories(NSAIDs), opioids, triptans, GABA modulators, Nav1.7 sodium channelblockers, CGRP inhibitors and/or cannabinoids, without this beinglimiting.

Thus, according to one embodiment, the composition to treat trigeminalnerve pains, in particular migraines, especially acute migraines, alsocomprises an analgesic, especially NSAIDs, aspirin and acetaminophen.

According to another embodiment, the composition to treat trigeminalnerve pains, in particular migraines, especially acute migraines, alsocomprises an NSAID, such as ibuprofen, diclofenac, piroxicam,ketoprofen, indomethacin, acetylsalicylic acid, celecoxib, naproxen.

According to another embodiment, the composition to treat trigeminalnerve pain, in particular migraines, especially acute migraines, alsocomprises an opioid, especially alfentanil, anileridine, buprenorphine,butorphanol, carfentanil, codeine, dextropropoxyphene, fentanyl,hydrocodone, hydromorphone, morphine, nalbuphine, oxycodone,oxymorphone, pentazocine, meperidine, propoxyphene, remifentanil,sufentanil, and tramadol. Advantageously, it is morphine or one of itsderivatives, especially morphine. Indeed, morphine is also able topotentiate the analgesic effect induced by the compounds according tothe invention.

According to another embodiment, the composition to treat trigeminalnerve pains, in particular migraines, especially acute migraines, alsocomprises a triptan, especially sumatriptan, naratriptan, zolmitriptan,eletriptan, almotriptan, frovatriptan, and/or rizatriptan.

GABA modulators are particularly carbamazepine, oxcarbazepine, baclofen,clonazepam, lamotrigine, gabapentin or pregabalin. Advantageously, it iscarbamazepine, gabapentin or pregabalin.

In particular, Nav 1.7 sodium channel inhibitors are described inZakrzewska J M et al., Lancet Neurol (2017), 16: 291-300 “Safety andefficacy of a Nav1.7 selective sodium channel blocker in patients withtrigeminal neuralgia: a double-blind, placebo-controlled, randomisedwithdrawal phase 2a trial” whose contents are incorporated here forreference.

Compositions of the invention to treat trigeminal nerve pains, inparticular migraines, especially acute migraines, can also comprise atleast one cannabinoid derivative, in particular Δ⁹ THC, or a protectorof its metabolism (Piomelli et al. review, TIPS (2000), 21: 218-224). Ithas actually been observed that the coadministration (simultaneous orstaggered in time) of small doses of cannabinoids (in particular, Δ⁹THC) potentiates the analgesic effects of the salts according to theinvention (salts of the compound of formula (I) or salts of formula(II)) without significantly inducing the detrimental effects ofcannabinoids, which appear intravenously (IV) at 4-5 mg/kg (sedation).In the sense of the present invention, “very low cannabinoid content”means cannabinoid contents less than those inducing said adverse sideeffects. In the sense of the present invention, “cannabinoids” means Δ⁹THC, synthetic CB1 receptor agonists or inhibitors of anandamidedegradation. The cannabinoids introduced into the composition accordingto the invention are preferably Δ⁹ THC.

According to a particular embodiment, the composition of the inventionto treat trigeminal nerve pains, in particular migraines, especiallyacute migraines, also comprises a second active ingredient chosen fromamong morphine, Δ⁹ THC, carbamazepine, oxcarbazepine, baclofen,clonazepam, lamotrigine, gabapentin or pregabalin, Nav1.7 sodium channelblockers, CGRP inhibitors, advantageously the second active ingredientis selected from morphine, Δ⁹ THC, gabapentin or Ia pregabalin.

Another object of the invention is a kit comprising:

1) a first composition comprising at least one compound of formula (I)such as defined previously, and

ii) a second composition comprising at least one second activeingredient useful to treat trigeminal nerve pain, in particularmigraines, for example acute migraines, especially selected fromanalgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids,triptans, GABA modulators and/or cannabinoids (advantageously chosenfrom morphine, Δ⁹ THC, oxcarbamazepine, baclofen, clonazepam,lamotrigine, gabapentin or pregabalin, Nav1.7 sodium channel blockersand CGRP inhibitors, preferably morphine, Δ⁹ THC, gabapentin orpregabalin), as combination products for simultaneous, separate, orstaggered use.

This kit can be used as a drug, especially in the treatment oftrigeminal nerve pains, such as migraine, trigeminal neuralgia orneuropathic pain associated with multiple sclerosis. Preferably, thiskit is used to treat acute migraines.

The present invention also concerns a composition comprising a quantitycomprised between 50 mg and 800 mg, of a salt of a compound of formula(I) or a salt of formula (II), in particular of compound 1.

According to a first variant, the present invention also concerns acomposition comprising a quantity comprised between 200 mg and 800 mg,of a salt of a compound of formula (I) or a salt of formula (II), inparticular of compound 1.

According to a second variant, the present invention also concerns acomposition comprising a quantity comprised between 100 mg and 400 mg,of a salt of a compound of formula (I) or a salt of formula (II), inparticular of compound 1.

According to a third variant, the present invention also concerns acomposition comprising a quantity comprised between 50 mg and 200 mg, ofa salt of a compound of formula (I) or a salt of formula (II), inparticular of compound 1.

According to one embodiment, the compositions such as described aboveare used for the treatment of trigeminal nerve pains. Preferably, thesecompositions are used for the treatment of migraines, for example acutemigraines.

Advantageously, these compositions may be administered to the patientsuffering from trigeminal nerve pains, in particular migraines, byfollowing the dosage regimen described above.

DESCRIPTION OF FIGURES

FIG. 1 : Tail withdrawal latency time (in seconds), for the controlgroup (with the carrier or 20 minutes after IP injection of a dose of 50mg/kg of compound 1), and for the EAE model group (with the carrier or20 minutes after injection of a dose of 50 mg/kg or 100 mg/kg ofcompound 1). Nociceptive thresholds are measured on D21, D28 and D35.Representation is done on D28. *: p<0.05 versus carrier control group orEAE (ANOVA+Newman-Keuls).

-   -   Nociceptive threshold (in seconds, Dn=threshold measurement day,        20 min after administration of compound 1 (PL37))

Before Compound 1, Compound 1, Day Injection 50 mg/kg 100 mg/kg ControlD21 2.69 5.12 (4) D28 3.0/2.69 4.14 (5) 5.98 (5) 4.85 (7) D35 2.69 5.46(5) 4.85 (7)

FIG. 2 : Headache/chronic migraine (chronic administration of ISDN): VonFrey force necessary to bring about head withdrawal (in g) as a functionof time, measured in minutes, after IV injection of a saline solution(carrier, black square), a solution of compound 1 (black circle) orsumatriptan (gray triangle).

FIG. 3 : Acute headache (1 administration of ISDN): Von Frey forcenecessary to bring about head withdrawal (in g) as a function of time,measured in minutes, after oral administration of a saline solution(carrier, black square), a solution of compound 1 (black circle) orrizatriptan (gray triangle).

FIG. 4 : Headache/chronic migraine (chronic administration of ISDN): VonFrey force necessary to bring about head withdrawal (in g) as a functionof time, measured in minutes, after oral administration of a salinesolution (carrier, black circle) or compound 1 (PL37) (gray circle, 50mg/kg)

FIG. 5 : Headache/chronic migraine (chronic administration of ISDN andcompound 1 (PL37))—Cutaneous sensitivity before administration ofcompound 1: Von Frey force necessary to bring about head withdrawal (ing) as a measured at t=0, before oral administration of a saline solution(carrier, black circle) or compound (gray circle, 50 mg/kg) measured for5 days

FIG. 6 : Headache/chronic migraine (chronic administration of ISDN andcompound 1 (PL37)): Von Frey force necessary to bring about headwithdrawal (in g) as a function of time, measured in minutes, after oraladministration of a saline solution (carrier, black circle) or compound1 (gray circle, 50 mg/kg) once daily

EXAMPLES

The invention will be further illustrated, without being limited, by theexamples below.

Example 1: Multiple Sclerosis Model (Experimental AutoimmuneEncephalitis, EAE)

The multiple sclerosis model can be induced in SJL mice, female albinowhite mice, by the administration of an emulsion made up of a myelinefragment and complete Freund® adjuvant (Aicher et al., Pain (2004), 110:560-570). Central nervous system inflammation appears at the end ofaround ten days=experimental autoimmune encephalomyelitis, or EAE.

Female SJL mice, purchased from Charles River Laboratories, arrive atthe age of 5 weeks and are immunized at the age of 6 weeks. Each mousereceives, under mask anesthesia (2% isoflurane), an emulsion of a volumeof 200 μL in the left flank, containing 150 μg of PLP₁₃₉₋₁₅₁(Proteolipid Protein Myelin, fragment 139-151) in 100 μL of sterile 0.9%NaCl as well as 100 μL of incomplete Freund® adjuvant (Sigma) completedby inactivated Mycobacterium tuberculosis (Difco, USA) at 4mg/mL=complete adjuvant.

The symptoms of the disease are reported between D10 and D15, which isreflected by an acute phase, during which scores are high and theanimals present a loss of pain sensitivity. This phase precedes achronic phase which starts around D18 and is characterized bystabilization of the animals general condition and the onset of asignificant lowering in the pain perception threshold (hyperalgic state)(Aicher et al., Pain (2004), 110: 560-570).

Nociceptive thresholds were determined from D12 by the tail immersiontest.

Compound 1 is administered IP (intraperitoneally) at 50 mg/kg and 100mg/kg in a EtOH/Tween 80/Water carrier (10/10/80) (100 μL per 10 g ofmice). The measurement of time of tail withdrawal from a 48° C. bath isdone at 20 min after injection (cut-off=10 sec).

The administration of compound 1 (PL37) at 50 and 100 mg/kg IP permitsreducing hyperalgesia in mice in a multiple sclerosis experimentalautoimmune encephalomyelitis (EAE) model (see FIG. 1 ).

Example 2: Migraine Attack Model

Migraine is a neurovascular disorder characterized by recurrent headacheattacks accompanied by variable neurological problems, includingcephalic cutaneous allodynia. This symptom is most common in migrainepatients. It affects 60 to 80% of chronic migraine patients (Guy et al.,Cephalalgia (2010), 30: 881-886; Lovatti, Expert Rev Neurother (2009),9: 395-408; Louter et al., Brain (2013), 136: 3489-3496). Moreover, theonset of allodynia is considered to be a risk factor for chronicmigraine (Louter et al., Brain (2013), 136: 3489-3496) and is alsoindicative of a state of central sensitization (Boyer et al., Pain(2014), 155: 1196-1205).

a) Persistent Allodynia Model Induced by Recurrent SystemicAdministration of Isosorbide Dinitrate (Migraine/Chronic Headache)

The effects of systemic administration of compound 1 on mechanicalcephalic allodynia were tested in rats in a migraine model induced byrepeated systemic injection of an NO donor, isosorbide dinitrate (ISDN).Indeed, the powerful vasodilating action of “NO donors” explains theirparticular propensity to trigger headache in healthy subjects andmigraine attacks in migraine patients (Hansen & Olesen, Cephalalgia(2017), 37: 11-19).

Animals

The experiments were conducted on male Sprague-Dawley CD rats (200-250g, Charles River Laboratories). A minimum delay of 7 days was respectedbefore any experimentation.

Assessment of Cephalic Cutaneous Sensitivity

The animals were first subjected to habituation sessions designed toreproduce the animals environmental conditions and handling by theexperimenter during the final test.

The mechanical sensitivity of the periorbital region was measured by thevon Frey test, which consists of applying a range of von Frey filamentsin this region, calibrated to exert a constant force (expressed ingrams) to determine the force (threshold) that leads to a headwithdrawal reaction. The rats were habituated to these tests for 5 dayspreceding the experiment for one hour, so that repeated measurementsgive reproducible results. At the end of the habituation period, themechanical pain sensitivity thresholds were 8 g on average (Boyer etal., Pain (2014), 155: 1196-1205; Dallel et al., Cephalalgia (2017),Jan. 1:333102417714032. doi: 10.1177/0333102417714032). These values arenot very painful since they consist of measuring a threshold with thepossibility of escape and do not lead to reactions other than headwithdrawal. The rats then received successive intraperitoneal injectionsof ISDN (10 mg/kg) and cutaneous sensitivity was assessed by means ofthe von Frey test. Mechanical allodynia developed progressively,reflected by a reduction in the values of the force necessary(thresholds) to induce head withdrawal. On the day of the experiment,the forces exerted by the von Frey filaments that led to head withdrawalwere measured in each rat under controlled conditions every 30 minutesfor 4 hours.

Assessment of Antimigraine Activity

On the day of experimentation, the rats received a first injection(intravenous) of physiological saline, sumatriptan or compound 1followed, 5 minutes later, by a second intraperitoneal injection of ISDN(10 mg/kg). The rat was then replaced in the observation box. The forcesinducing head withdrawal were measured every 30 minutes for 4 hours, tofollow the kinetics of the effect.

3 groups were made up:

-   -   1 control group: intravenous injection of physiological saline        (n=10)    -   1 test group: intravenous injection of compound 1 (20 mg/kg;        n=10)    -   1 reference group: intravenous injection of sumatriptan (300        μg/kg; n=10) Data analysis A two-way analysis of variance        (effect of time and treatment) was done by repeated measurements        and was followed by a post-hoc test. The results are presented        in FIG. 2 .

It is observed that compound 1—administered intravenously at the dose of20 mg/kg—considerably reduces cephalic cutaneous sensitivity, which issignificant for a reduction in associated migraine activity, in chronicconditions.

b) Mechanical Allodynia Model Induced by Single Administration ofIsosorbide Dinitrate (Acute Migraine/Headache)

The effects of systemic administration of compound 1 on mechanicalcephalic allodynia were tested in rats in a migraine model induced bysingle systemic injection of an NO donor, isosorbide dinitrate (ISDN).Indeed, the powerful vasodilating action of “NO donors” explains theirparticular propensity to trigger headache in healthy subjects andmigraine attacks in migraine patients (Hansen & Olesen, Cephalalgia(2017), 37: 11-19).

Animals

The experiments were conducted on male Sprague-Dawley CD rats (200-250g, Charles River Laboratories). A minimum delay of 7 days was respectedbefore any experimentation.

Assessment of Cephalic Cutaneous Sensitivity

The animals were first subjected to habituation sessions designed toreproduce the animals environmental conditions and handling by theexperimenter during the final test.

The mechanical sensitivity of the periorbital region was measured by thevon Frey test, which consists of applying a range of von Frey filamentsin this region, calibrated to exert a constant force (expressed ingrams) to determine the force (threshold) that leads to a headwithdrawal reaction. The rats were habituated to these tests for 5 dayspreceding the experiment for one hour, so that repeated measurementsgive reproducible results. At the end of the habituation period, themechanical pain sensitivity thresholds were 8 g on average (Boyer etal., Pain (2014), 155: 1196-1205; Dallel et al., Cephalalgia (2017),Jan. 1:333102417714032. doi: 10.1177/0333102417714032). These values arenot very painful since they consist of measuring a threshold with thepossibility of escape and do not lead to reactions other than headwithdrawal. The rats then received an intraperitoneal injection of ISDN(10 mg/kg) and cutaneous sensitivity was assessed by means of the vonFrey test. Mechanical allodynia developed progressively, reflected by areduction in the values of the force necessary (thresholds) to inducehead withdrawal. On the day of the experiment, the forces exerted by thevon Frey filaments that led to head withdrawal were measured in each ratunder controlled conditions every 30 minutes for 4 hours.

Assessment of Antimigraine Activity

On the day of experimentation, the rats received a first injection(oral) of physiological saline, rizatriptan (10 μg/kg) or compound 1 (50mg/kg) followed, 5 minutes later, by an intraperitoneal injection ofISDN (10 mg/kg). The rat was then replaced in the observation box. Theforces inducing head withdrawal were measured every 30 minutes for 4hours, to follow the kinetics of the effect.

3 groups were made up:

-   -   1 control group: oral administration of physiological saline        (n=10)    -   1 test group: oral administration of compound 1 (50 mg/kg; n=10)    -   1 reference group: oral administration of rizatriptan (10 μg/kg;        n=10)

Data Analysis

A two-way analysis of variance (effect of time and treatment) was doneby repeated measurements and was followed by a post-hoc test. Theresults are presented in FIG. 3 .

It is observed that compound 1—administered orally at the dose of 50mg/kg—considerably reduces cephalic cutaneous sensitivity, which issignificant for a reduction in the intensity of the acute migraineattack.

Example 3: Model for Prevention of Migraine Attacks by OralAdministration

The effects of oral administration of compound 1 on mechanical cephalicallodynia were tested in rats in a chronic migraine model induced byrepeated systemic injection of an NO donor, isosorbide dinitrate (ISDN).Indeed, the powerful vasodilating action of “NO donors” explains theirparticular propensity to trigger headache in healthy subjects andmigraine attacks in migraine patients (Hansen & Olesen, Cephalalgia(2017), 37: 11-19).

Animals

The experiments were conducted on male rats (10 rats per group of theSprague-Dawley CD strain (200-250 g, Charles River Laboratories),randomly assigned into each group before experimentation. A minimumdelay of 7 days was respected before any experimentation. Theexperiments were conducted with the experimenter blinded.

Assessment of Cephalic Cutaneous Sensitivity

The animals were first subjected to habituation sessions designed toreproduce the animals environmental conditions and handling by theexperimenter during the final test.

The mechanical sensitivity of the periorbital region was measured by thevon Frey test, which consists of applying a range of von Frey filamentsin this region, calibrated to exert a constant force (expressed ingrams) to determine the force (threshold) that leads to a headwithdrawal reaction. The rats were habituated to these tests for 5 dayspreceding the experiment for one hour, so that repeated measurementsgive reproducible results. At the end of the habituation period, themechanical pain sensitivity thresholds were 8 g on average (Boyer etal., Pain (2014), 155: 1196-1205; Dallel et al., Cephalalgia (2017),Jan. 1:333102417714032. doi: 10.1177/0333102417714032). These values arenot very painful since they consist of measuring a threshold with thepossibility of escape and do not lead to reactions other than headwithdrawal. The rats then received successive intraperitoneal injectionsof ISDN (10 mg/kg) and cutaneous sensitivity was assessed by means ofthe von Frey test. Mechanical allodynia developed progressively,reflected by a reduction in the values of the force necessary(thresholds) to induce head withdrawal.

Cutaneous mechanical sensitivity was measured before and on the test day(FIG. 4 , single administration of compound 1 or FIG. 6 , repeatedadministration of compound 1) or before and on the test day (Days 1, 2,3, 4 and 5) (FIG. 5 , repeated administration of compound 1) beforeinjection and at 30 min intervals for 4 h in the different groups ofrats receiving intraperitoneal ISDN (10 mg/kg, volume of 10 mL/kg).

Assessment of Antimigraine Activity

On the day of experimentation, the rats received a first oraladministration of carrier (10% EtOH in 0.9% NaCl physiological saline)or compound 1 (50 mg/kg in the carrier) followed, 5 minutes later, by asecond intraperitoneal injection of ISDN (10 mg/kg). The rat was thenreplaced in the observation box. The forces inducing head withdrawalwere measured every 30 minutes for 4 hours, to follow the kinetics ofthe effect.

Data Analysis

A two-way analysis of variance (effect of time and treatment) was doneby repeated measurements and was followed by a post-hoc test.

Compound 1—administered orally at the dose of 50 mg/kg once on theexperiment day (FIG. 4 ) had no effect on cutaneous cephalicsensitivity. Compound 1, administered repeatedly over several days (5days) significantly reduces cutaneous cephalic sensitivity compared tothe carrier one day compared to the previous one, before administrationof ISDN (FIG. 5 ) or as a function of time, after administration of ISDN(FIG. 6 ), which is significant for prevention and reduction ofassociated migraine activity, in chronic condition.

Example 4: Dosage Regimen for Compound 1—Study of Adverse EffectsObserved During Phase 1b of the Clinical Study for Compound 1 (PL37)

Details on the Experimental Conditions

Forty healthy volunteers aged 18 to 65 randomly divided into five groupsof 8 subjects (6 groups receiving four daily doses of compound 1 (PL37),and two groups receiving four daily doses of placebo)

The doses indicated in the following table were administered 4 times aday for 5 days, the daily dose varying from 800 to 4000 mg, the totalquantity over five days being comprised between 4000 and 20,000 mg.

Compound 1 (PL37) 200 mg 400 mg 600 mg 800 mg 1000 mg Placebo Total N =6 N = 6 N = 6 N = 6 N = 6 N = 10 N = 40 n (%) E n (%) E n (%) E n (%) En (%) E n (%) E n (%) E Subjects with: TEAEs 1(16.7)3 5(83.3)12 4(66.7)76(100.0)10 4(66.7)15 5(50.0)10 25(62.5)57 LAE 0 0 0 0 0 0 0 SAE 0 0 0 00 0 0 Death 0 0 0 0 0 0 0 E = number of adverse reactions n = number ofsubjects who had adverse reactions N = number of subjects per treatmentgroup LAE = limiting adverse event TEAEs = treatment-emergent adverseevent SAE = serious adverse event

What is claimed:
 1. A method for preventing or treating atrigeminal-nerve related pain in a subject in need thereof, comprisingadministering to the subject a composition comprising as activeingredient at least one pharmaceutically-acceptable salt of a compoundof formula (I) and at least one pharmaceutically-acceptable excipient,wherein the compound of formula (I) isH₂N—CH(R₁)—CH₂—S—S—CH₂—CH(R₂)—CONH—CH(R₃)—COOR₄  (I) wherein: R₁ is: (i)a saturated or unsaturated, linear or branched hydrocarbon chain,containing 1 to 6 carbon atoms, optionally substituted by: an OR, SR orS(O)R radical, wherein R is a hydrogen, a linear or branched hydrocarbonchain of 1 to 4 carbon atoms, a phenyl radical or a benzyl radical, or aphenyl or benzyl radical, (ii) a phenyl or benzyl radical optionallysubstituted by: 1 to 5 halogens, or an OR, SR or S(O)R radical, whereinR is a hydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbonatoms, a phenyl radical, or a benzyl radical, or a methylene radicalsubstituted by a 5 or 6 atom heterocycle, aromatic or saturated, havinga nitrogen or sulfur atom as heteroatom, optionally oxidized in the formof N-oxide or S-oxide; R₂ is: (i) a phenyl or benzyl radical optionallysubstituted by: 1 to 5 halogens, an OR or SR radical, wherein R is ahydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbon atoms,a phenyl radical, or a benzyl radical, an amino group, optionally mono-or disubstituted by a cyclic or linear aliphatic group, of 1 to 6 carbonatoms, a 5 or 6 atom aromatic ring, or an aromatic heterocycle ring with5 to 6 atoms, the heteroatom being an oxygen, nitrogen or sulfur, or(ii) a methylene group substituted by a 5 or 6 atom heterocycle,aromatic or saturated, being an oxygen, nitrogen or sulfur, the nitrogenand sulfur atoms optionally being oxidized in the form of N-oxide orS-oxide; R₃ is: (i) a hydrogen, (ii) an OH or OR group, wherein R is ahydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbon atoms,a phenyl radical or a benzyl radical, (iii) a saturated hydrocarbon(alkyl) chain, linear or branched, having 1 to 6 carbon atoms,optionally substituted by an OR or SR radical, R is a hydrogen, a linearor branched hydrocarbon chain of 1 to 4 carbon atoms, a phenyl radical,or a benzyl radical, (iv) a phenyl radical or a benzyl radical,optionally substituted by 1 to 5 halogens, or an OR or SR group, whereinR is a hydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbonatoms, a phenyl radical, or a benzyl radical, and OR₄ is: (i) aglycolate OCH₂COOR′ or lactate OCH(CH₃)COOR′ radical, (ii) anOCH(R″)O(CO)OR′ or OCH(R″)O(CO)R′ group, (iii) an OCH(CH₂OCOR′)₂ orOCH₂—CH(OCOR′)—CH₂OCOR′ triglyceride radical, (iv) a glycoside radical,(v) a sulfonate OCH₂CH₂(SO₂)CH₃ radical, or (vi) an OCH(CH₂OH)₂ radical,wherein, in each of these radicals, R □ is: a linear or branched C₁-C₆alkyl optionally substituted by a C₁-C₃ alkoxy group, a C₅-C₈,cycloalkyl group, a phenyl group, a benzyl group, a heteroaryl group, oran alkyl heteroaryl group; and R″ is: a hydrogen atom, a linear orbranched C₁-C₆ alkyl chain optionally substituted by a C₁-C₃ alkoxygroup, a C₅-C₈, cycloalkyl group, a phenyl group, a benzyl group, aheteroaryl group, or an alkyl heteroaryl group.
 2. The method of claim1, wherein the composition further comprises a second active ingredientuseful to prevent or treat trigeminal nerve pains.
 3. The method ofclaim 2, comprising administering the composition for preventing atrigeminal-nerve related pain, and wherein the second active ingredientis selected from beta blockers, antidepressants, anticonvulsants,calcium channel blockers and/or CGRP inhibitors.
 4. The method of claim3, wherein the second active ingredient is one or more of propranolol,amitriptyline and topiramate.
 5. The method of claim 2, comprisingadministering the composition for treating a trigeminal-nerve relatedpain and wherein the second active ingredient is selected from one ormore of analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs),opioids, triptans, GABA modulators, Nav 1.7 sodium channel blockers,CGRP inhibitors and cannabinoids.
 6. The method of claim 1, wherein thesalt of a compound of formula (I) is a fumarate salt.
 7. The method ofclaim 1, wherein the salt of a compound of formula (I) is apharmaceutically-acceptable salt selected from the group consisting of:1-(2-(1-(2,3-diacetoxypropoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-ylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(2-methanesulfonylethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-ylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(1-ethoxycarbonyloxyethoxycarbonyl))-ethylcarbamoyl)-3-thiophen-3-yl-propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-ethoxycarbonylmethyloxycarbonylethylcarbamoyl)-3-thiophen-3-yl-propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(1-ethoxycarbonyloxyethoxycarbonyl)-2-hydroxypropylcarbamoyl)-3-thiophen-3-ylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(2-acetoxy-1-acetoxymethylethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-ylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(2-hydroxy-1-hydroxymethylethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-ylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(3,4,5,6-tetrahydroxytetrahydropyran-2-ylmethoxycarbonyl)-ethylcarbamoyl)-3-thiophen-3-yl-propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(1-ethoxycarbonyloxy-ethoxycarbonyl)-2-hydroxypropylcarbamoyl)-3-phenylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-(1-(2-acetoxy-1-acetoxymethyl-ethoxycarbonyl)-2-hydroxypropylcarbamoyl)-3-phenylpropyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,1-(2-((1-ethoxycarbonyloxy-ethoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanylpropyl-amine,3-(2-amino-4-methylsulfanyl-butyldisulfanyl)-2-benzyl-N-(5-ethyl-(1,3,4)-thiadiazol-2-yl)-propionamide,1-(2-((1-ethoxycarbonyloxy-2-methyl-propoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,1-(2-((cyclohexyl-ethoxycarbonyloxy-methoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,1-(2-((ethoxycarbonyloxy-phenyl-methoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,3-methylsulfanyl-1-(3-phenyl-2-((1-propionyloxy-ethoxycarbonylmethyl)-carbamoyl)-propyldisulfanylmethyl)-propyl-amine,1-(2-((2-methyl-1-propionyloxy-propoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,1-(2-((cyclohexyl-propionyloxy-methoxycarbonylmethyl)-carbamoyl)-3-phenyl-propyldisulfanylmethyl)-3-methylsulfanyl-propyl-amine,and3-methylsulfanyl-1-(3-phenyl-2-((phenyl-propionyloxy-methoxycarbonylmethyl)-carbamoyl)-propyldisulfanylmethyl)-propyl-amine.
 8. The method of claim 1, wherein thesalt of a compound of formula (I) is(5S,10S)-10-benzyl-16-methyl-11,14,18-trioxo-15,17,19-trioxa-2,7,8-trithia-12-azahenicosan-5-aminiumfumarate.
 9. The method of claim 1, comprising administering atherapeutic dose comprising between 200 and 800 mg of the salt of acompound of formula (I) to the patient in need thereof.
 10. The methodof claim 1, comprising administering the composition for preventing ortreating migraines or trigeminal neuralgia.
 11. The method of claim 1,comprising administering the composition for preventing or treatingessential trigeminal neuralgia, symptomatic trigeminal neuralgia,migraines, cephalic cutaneous allodynia, cluster headaches, orperipheral trigeminal pain associated with multiple sclerosis.
 12. Themethod of claim 1, comprising administering the composition forpreventing migraine attacks.
 13. The method of claim 3, comprisingadministering the composition for preventing migraines or trigeminalneuralgia.
 14. The method of claim 3, comprising administering thecomposition for preventing essential trigeminal neuralgia, symptomatictrigeminal neuralgia, migraines, cephalic cutaneous allodynia, clusterheadaches, or peripheral trigeminal pain associated with multiplesclerosis.
 15. The method of claim 5, comprising administering thecomposition for treating migraines or trigeminal neuralgia.
 16. Themethod of claim 5, comprising administering the composition for treatingessential trigeminal neuralgia, symptomatic trigeminal neuralgia,migraines, cephalic cutaneous allodynia, cluster headaches, orperipheral trigeminal pain associated with multiple sclerosis.
 17. Themethod of claim 1, further comprising administering another compositioncomprising at least an active ingredient useful to treat trigeminalnerve pains, wherein both compositions are provided as combinationproducts for simultaneous, separate or staggered administration.
 18. Acomposition comprising 50 to 800 mg of a salt of compound of formula(I):H₂N—CH(R₁)—CH₂—S—S—CH₂—CH(R₂)—CONH—CH(R₃)—COOR₄  (I) wherein: R₁ is: (i)a saturated or unsaturated, linear or branched hydrocarbon chain,containing 1 to 6 carbon atoms, optionally substituted by: an OR, SR orS(O)R radical, wherein R is a hydrogen, a linear or branched hydrocarbonchain of 1 to 4 carbon atoms, a phenyl radical or a benzyl radical, or aphenyl or benzyl radical, (ii) a phenyl or benzyl radical optionallysubstituted by: 1 to 5 halogens, or an OR, SR or S(O)R radical, whereinR is a hydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbonatoms, a phenyl radical, or a benzyl radical, or a methylene radicalsubstituted by a 5 or 6 atom heterocycle, aromatic or saturated, havinga nitrogen or sulfur atom as heteroatom, optionally oxidized in the formof N-oxide or S-oxide; R₂ is: (i) a phenyl or benzyl radical optionallysubstituted by: 1 to 5 halogens, an OR or SR radical, wherein R is ahydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbon atoms,a phenyl radical, or a benzyl radical, an amino group, optionally mono-or disubstituted by a cyclic or linear aliphatic group, of 1 to 6 carbonatoms, a 5 or 6 atom aromatic ring, or an aromatic heterocycle ring with5 to 6 atoms, the heteroatom being an oxygen, nitrogen or sulfur, or(ii) a methylene group substituted by a 5 or 6 atom heterocycle,aromatic or saturated, being an oxygen, nitrogen or sulfur, the nitrogenand sulfur atoms optionally being oxidized in the form of N-oxide orS-oxide; R₃ is: (i) a hydrogen, (ii) an OH or OR group, wherein R is ahydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbon atoms,a phenyl radical or a benzyl radical, (iii) a saturated hydrocarbon(alkyl) chain, linear or branched, having 1 to 6 carbon atoms,optionally substituted by an OR or SR radical, R is a hydrogen, a linearor branched hydrocarbon chain of 1 to 4 carbon atoms, a phenyl radical,or a benzyl radical, (iv) a phenyl radical or a benzyl radical,optionally substituted by 1 to 5 halogens, or an OR or SR group, whereinR is a hydrogen, a linear or branched hydrocarbon chain of 1 to 4 carbonatoms, a phenyl radical, or a benzyl radical, and OR₄ is: (i) aglycolate OCH₂COOR′ or lactate OCH(CH₃)COOR′ radical, (ii) anOCH(R″)O(CO)OR′ or OCH(R″)O(CO)R′ group, (iii) an OCH(CH₂OCOR′)₂ orOCH₂—CH(OCOR′)—CH₂OCOR′ triglyceride radical, (iv) a glycoside radical,(v) a sulfonate OCH₂CH₂(SO₂)CH₃ radical, or (vi) an OCH(CH₂OH)₂ radical,wherein, in each of these radicals, R □ is: a linear or branched C₁-C₆alkyl optionally substituted by a C₁-C₃ alkoxy group, a C₅-C₈,cycloalkyl group, a phenyl group, a benzyl group, a heteroaryl group, oran alkyl heteroaryl group; and R″ is: a hydrogen atom, a linear orbranched C₁-C₆ alkyl chain optionally substituted by a C₁-C₃ alkoxygroup, a C₅-C₈, cycloalkyl group, a phenyl group, a benzyl group, aheteroaryl group, or an alkyl heteroaryl group, a pharmaceuticallyacceptable excipient and a second active ingredient useful to prevent ortreat trigeminal nerve pains.
 19. The composition of claim 18, whereinthe second active ingredient is useful to treat migraine.